丁苯酞注射液治疗急性脑梗死患者的临床疗效观察

张伟平; 骆嵩; 黄显军

doi:10.16766/j.cnki.issn.1674-4152.004332

丁苯酞注射液治疗急性脑梗死患者的临床疗效观察

doi: 10.16766/j.cnki.issn.1674-4152.004332

1.
铜陵市人民医院(蚌埠医科大学附属铜陵医院)神经内科, 安徽铜陵 244000
2.
蚌埠医科大学第一附属医院神经内科，安徽蚌埠 233004
3.
皖南医学院弋矶山医院神经内科，安徽芜湖 241000

基金项目:

安徽高校自然科学研究项目 KJ2021A0843

详细信息

通讯作者:
张伟平，E-mail: zzzwwwppp123@qq.com

中图分类号: R743.3
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出版历程
- 收稿日期: 2025-07-11
- 网络出版日期: 2026-04-01

Observation on the clinical efficacy of butylphthalide injection in the treatment of acute cerebral infarction

1.
Department of Neurology, Tongling People's Hospital (Affiliated Tongling Hospital of Bengbu Medical University), Tongling, Anhui 244000, China

摘要

摘要: 目的在急性脑梗死(acute cerebral infarction，ACI)患者的临床治疗中，予以丁苯酞注射液干预，观察记录患者的治疗效果。方法选取2021年6月—2024年6月铜陵市人民医院126例急性脑梗死患者，按随机数字表法分为观察组与对照组，每组各63例。2组均予常规药物治疗，观察组加用丁苯酞注射液，疗程2周。统计分析2组神经功能缺损(NIHSS)、日常生活能力(ADL)评分，外周血IL-23、巨噬细胞炎症因子1α(MIP-1α)等炎症指标，超氧化物歧化酶(SOD)与谷胱甘肽过氧化物酶(GSH-PX)以及一氧化氮(NO)水平等氧化应激指标及不良反应发生率。结果观察组治疗有效率为92.06%(58/63)，显著高于对照组的73.02%(46/63)，差异有统计学意义(χ²=5.714，P＜0.001)；与对照组比较，观察组在辅以丁苯酞注射液治疗后NIHSS评分明显降低(P＜0.01)，ADL评分显著升高(P＜0.01)，日常生活能力显著增强(P＜0.01)，氧化应激指标SOD、GSH-PX以及NO水平明显升高(P＜0.01)，炎症指标IL-23与MIP-1α水平显著降低(P＜0.01)。2组患者均未出现明显的不良反应。结论在临床常规治疗的基础上加以丁苯酞注射液治疗，可显著提升治疗有效率，有助于患者神经功能与生活能力的恢复，明显降低炎性反应，抑制氧化应激反应，更利于血管内皮功能的恢复，安全性能较好，能显著提高患者的生活质量。
- 急性脑梗死 /
- 丁苯酞注射液 /
- 炎性因子 /
- 氧化应激 /
- 神经功能
Abstract: Objective To observe and evaluate the therapeutic effect of butylphthalide injection in the clinical treatment of patients with acute cerebral infarction (ACI). Methods A total of 126 ACI patients admitted to Tongling People' s Hospital from June 2021 to June 2024 were selected and divided into an observation group and a control group by a random number table method, with 63 cases in each group. Both groups received conventional drug treatment, while the observation group was additionally given butylphthalide injection for a treatment course of 2 weeks. The National Institutes of Health stroke scale (NIHSS) score, activities of daily living (ADL) score, inflammatory indicators (peripheral blood IL-23 and macrophage inflammatory protein-1α (MIP-1α), oxidative stress indicators superoxide dismutase (SOD), glutathione peroxidase (GSH-PX), and the nitric oxide (NO) levels, and the adverse reaction rate were statistically compared between the two groups. Results The total effective rate in the observation group was 92.06% (58/63), which was significantly higher than 73.02% (46/63) of the control group, with a statistically significant difference (χ²=5.714, P < 0.001). After treatment, the observation group showed significantly lower NIHSS scores (P < 0.01) and significantly higher ADL scores than the control group (P < 0.01), indicating enhanced daily living ability (P < 0.01). In addition, oxidative stress indicators (SOD, GSH-PX and NO levels) were significantly increased (P < 0.01), while inflammatory indicators (IL-23 and MIP-1α levels) were significantly reduced in the observation group (P < 0.01). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion On the basis of conventional clinical treatment, the addition of butylphthalide injection significantly improves the therapeutic effect, promotes the recovery of neurological function and daily living ability in patients, reduces inflammatory response, inhibits oxidative stress. The treatment demonstrates good safety and contributes to life quality improvement in affected patients.
- Acute cerebral infarction /
- Butylphthalide injection /
- Inflammatory factors /
- Oxidative stress /
- Neurological function

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表 1 2组急性脑梗死患者一般资料比较

Table 1. Comparison of general data of two groups of patients with acute cerebral infarction

组别	例数	性别(男/女，例)	年龄(x±s，岁)	BMI(x±s)	梗死位置(例)
组别	例数	性别(男/女，例)	年龄(x±s，岁)	BMI(x±s)	基底节	额顶叶	其他
观察组	63	36/27	62.1±3.5	23.23±3.35	27	18	18
对照组	63	40/23	63.5±3.3	23.89±3.06	29	15	19
统计量		0.395^a	0.095^b	0.352^b	0.857^a
P值		0.417	0.796	0.983	0.944
注：^a为χ²值，^b为t值。

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表 2 2组急性脑梗死患者治疗前后NIHSS评分比较(x±s, 分)

Table 2. Comparison of NIHSS scores before and after treatment in two groups of patients with acute cerebral infarction(x±s, 分)

组别	例数	治疗前	治疗后	t值	P值
观察组	63	12.89±4.38	6.31±2.38	15.237	＜0.001
对照组	63	13.63±3.62	7.91±2.74	16.894	＜0.001
统计量		0.653^a	12.415^b
P值		0.847	＜0.001
注：^a为t值，^b为F值。

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表 3 2组急性脑梗死患者治疗前后ADL评分比较(x±s, 分)

Table 3. Comparison of ADL scores before and after treatment in two groups of patients with acute cerebral infarction(x±s, points)

组别	例数	治疗前	治疗后	t值	P值
观察组	63	46.7±5.16	82.1±9.68	18.425	＜0.001
对照组	63	43.9±6.21	67.8±12.73	17.638	＜0.001
统计量		2.613^a	9.872^b
P值		0.322	＜0.001
注：^a为t值，^b为F值。

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表 4 2组急性脑梗死患者治疗前后IL-23、MIP-1α水平比较(x±s，pg/mL)

Table 4. Comparison of IL-23 and MIP1α levels before and after treatment in two groups of patients with acute cerebral infarction(x±s, pg/mL)

组别	例数	IL-23		t值	P值	MIP-1α		t值	P值
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
观察组	63	68.39±8.28	32.33±4.53	22.147	＜0.001	36.23±5.13	12.31±1.79	25.683	＜0.001
对照组	63	67.68±8.37	44.78±4.94	19.325	＜0.001	35.83±4.96	17.78±1.53	20.417	＜0.001
统计量		0.219^a	18.934^b			0.369^a	15.672^b
P值		0.813	＜0.001			0.947	＜0.001
注：^a为t值，^b为F值。

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表 5 2组急性脑梗死患者治疗前后氧化应激指标比较(x±s)

Table 5. Comparison of oxidative stress indicators before and after treatment in two groups of patients with acute cerebral infarction(x±s)

组别	例数	SOD(U/mL)		t值	P值	GSH-PX(U/mL)		t值	P值	NO(μM)		t值	P值
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
观察组	63	78.31±11.45	119.37±17.56	16.892	＜0.001	87.73±6.32	113.90±13.58	18.435	＜0.001	47.14±7.78	71.93±9.84	17.284	＜0.001
对照组	63	79.60±9.84	97.48±16.94	15.732	＜0.001	88.21±7.08	106.54±14.84	16.847	＜0.001	48.62±7.63	60.62±9.84	14.926	＜0.001
统计量		0.998^a	6.524^b			0.764^a	5.893^b			0.981^a	7.215^b
P值		0.813	＜0.001			0.509	＜0.001			0.704	＜0.001
注：^a为t值，^b为F值。

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表 6 2组急性脑梗死患者临床总有效率比较[例(%)]

Table 6. Comparison of the overall clinical effectiveness rates of the two groups of patients with acute cerebral infarction[cases(%)]

组别	例数	基本痊愈	显效	有效	无效	总有效
观察组	63	6(9.52)	25(39.68)	27(42.86)	5(7.94)	58(92.06)
对照组	63	3(4.76)	21(33.33)	22(34.92)	17(26.98)	46(73.02)
注：2组总有效率比较，χ²=5.714, P＜0.001。

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